People doing it better

This is the first in a series of responses to comments that were recently posted on my Aspartame and Formaldahyde entry, the bulk of them by Betty Martini. I am placing the responses here to create a new place for any comments that follow and also to allow the content to be more readily available when the same material comes up again (my blog is certainly not the only place that these comments have been placed, the bulk of it is material has been submitted to Usenet and any blogs discussing aspartame since the 90s). I am perhaps wasting my time responding to them, but I feel like so many of these claims have been left unchallenged for too many years.

Here goes…

Was the New Mexico Legislature “misled”?

This is a document that was essentially intended as a rebuttal to statements that John E. Garst (a frequent commenter here) made regarding aspartame as part of efforts to prevent the New Mexico legislature from banning its use. As best I can tell, the bills never even got out of committee.

Sidebar: NM legislature submitted bills on the banning of aspartame

It seems that one state senator, Gerald Ortiz y Pino, made it a practice to just keep submitting the “rescind aspartame approval” bills, even though they didn’t go anywhere (simply getting submitted and going to “action postponed indefinitely”, API, status. In other words, dying) – SB 250 (2006), SB 654 (2006) . But there were also attempts in the House, by one Irvin Harrison. In the failed API’d HB 202 (2006) and HB 391 (2007), its clear that whoever wrote these bills bought into the unscientific, and unsubstantiated, claims of the anti-aspartame movement. They seem to have the same text, so here’s the representative portion:

“The legislature finds it is imperative for the public health, safety and welfare to declare that aspartame and its derivative compounds, in all of their trade names, are poisonous and deleterious food additives due to their neurotoxic and carcinogenic metabolites.”

Simply read any of the articles from my “Aspartame” section to see that these claims are simply not credible. If you read theminutes of the sessions, in both cases it is newspaper editor/writer Stephen Fox who is the constituent asking for the ban of aspartame. The minutes said that he presented a document called “Report for Schools, OB-GYN and Pediatricians on Children and Aspartame/MSG”. I won’t leave the reader in suspense about who the authors of that “report” were: Ralph Walton, Russell Blaylock, and HJ Roberts, Joe Mercola, the Feingold Association, and “prepared” by Betty Martini. So the actions of the Ortiz, Harrison and Fox were not exactly chance occurences that our friends from wnho.net stumbled upon.

It’s clear that the attempt by two members of the New Mexico legislature did not introduce anything new to the case, and, even and they succeeded, would not have “proved” anything. One only look at the fact that the US Congress has Creationists as part of its Science and Technology Committee.

And now onto the claims

At the say so level: R G Walton M.D. Chairman, Center for Behavioral Medicine at NE Ohio College of Medicine analyzed 92 peer-reviewed studies not funded by aspartame industry. 92% found PROBLEMS!

…

In 95 the FDA listed 92 reactions from 10,000 volunteered complaints, including death.

This lists of “92 peer-reviewed studies” by Walton and “92 reactions” from FDA seem to have become a centerpiece of the anti-aspartame movement. I have already covered the Walton list and, long story short, most of the studies either have nothing to do with aspartame or aren’t even a peer-reviewed study at all. There’s also not actually 92 as some are duplicates. Being very generous, 5 of the entries are both peer-reviewed and potentially relate in some “negative” way to aspartame (but you can view the above link andy my spreadsheet to see the details). The FDA list has also been discussed (Extraordinary claims about aspartame and Sweet Misery Fact Check)

H. J. Roberts, M.D., FACP a diabetic specialist has produced 20 books and his first text on medical diagnosis was used by 60,000 doctors to prepare for their Board examinations.

As the name of the book is not mentioned, this claim is difficult to check. The closest thing I can find to a textbook from Roberts is “Aspartame Disease: An Ignored Epidemic”. But perhaps it is “Useful insights for diagnosis, treatment, and public health” ? If Betty Martini can clarify this statement, which she made multiple times in my blog comments, I can better track down the truth and/or relevance of this claim.

(from section quoting H.J. Roberts)

*The assertion that methanol concentrations never are very high after aspartame ingestion is erroneous. I devoted an entire chapter to methanol toxicity in my text, Aspartame Disease: An Ignored Epidemic (pp 668-685), and show in Figure XXI-1 the dose-related blood levels of methanollasting 8 or more hours.

This is a common tactic of the anti-aspartame folks, redirecting the reader to the dangers of methanol toxicity, which are well known and not disputed. The issue is that aspartame does not actually lead to a large amount of methanol in the body, so it’s not a relevant comparison.

There is another bullet point that addresses John E. Garst’s comments about folate deficiency, saying that its not as widespread and then saying the problem is really phenylalanine. I don’t really have any notes about folate deficiency, so will let John respond if he wants. However, bringing up phenylalanine as part of the “aspartame disease” is also a bit pointless given the low volumes of phenylalanine compared to other foods (bananas, eggs, milk, meat).

Remember that Dr. Alemanys study proved the formaldehyde converted from the free methyl alcohol embalms living tissue and damages DNA. As we know when you damage DNA you can destroy humanity

Appeal to emotion here… the Trocho study (not “Alemanys”, Alemany is the last name listed) did no such thing and a response to it (well, a citation to the actual response) can be found in the very article that was being commented on.

Even the FDA found many types of tumors and brain cancer on original studies and the Ramazzini Study in 2005 confirmed FDA findings reporting the study showed aspartame to be a multipotential carcinogen.

The Ramazzini study has been decimated by both the FDA and the European EFSA. In fact, in 2009 the EFSA reaffirmed their original 2006 response. Not sure what the “FDA found many types of tumors” is referring to exactly, as there is no citation. But the FDA is certainly ok with the safety of aspartame, so its a bit moot.

Believe it or not, the referenced link document is actually the one that kick-started my interest in aspartame and led to the writing of “Aspartame and Formaldehyde”. That article is essentially a direct response to the Mark Gold link.

Does a 1970 “Trade Secret” document from Searle reveal an intent to hide DKP dangers?

Maybe the list would like to see the secret trade information which the manufacturer did give in congressional hearings. Even the hearings are on http://www.mpwhi.com/trade_secret_information_on_aspartame.htm. Notice the last paragraph where they admitted they had to conclude almost complete conversion to DKP, the brain tumor agent. What they are saying if they let the FDA they won’t get it approved.

This is a link to a page that refers to a memo from a “Mr. Helling” with a subject of “Food and Drug Sweetener Strategy” and dated December 28, 1970. Taking for granted that the document is legitimate, it discusses some admittedly shady-sounding ideas for getting “Food & Drug” to say “yes”. Having been around sales people, none of that is new nor, I’d argue, particularly relevant to the safety. More relevant is the section discussing DKP. In it they seem to look to get approval for products which would have the least change of breakdown to DKP, namely dry foods or ones which have an acid ingredient. Quoting the Hellig document itself: “If we select foods that have their storage in dry form particularly if they are formulated so there is an acid ingredient, then we would have confidence that the SC-18362 would not break down measurably during the usual maximum storage periods… [such as] a pre-sweetened cereal product that’s consumed cold.”

They go on to discuss other products in different categories, all with the goal of avoiding the breakdown to DKP, especially until they have more data about DKP.

They also note that they believe that “based on the toxicity data that we have in the feeding studies, we expect to get approvals”

Martini’s statement about the last paragraph is a complete misrepresentation. What the last paragraph actually says is that they should not try go for “spoon-for-spoon” (i.e. in place of sugar by consumers) use because they have no way of estimating maximum usage and therefore would need to assume a maximum conversion to DKP. This is just complementing the rest of the document discussing what they see as the safe usage based on their DKP studies.

I flew to Barcelona to see Dr. Maria Alemany who did the Trocho Study showing the formaldehyde from the free methyl alcohol embalms living tissue. The first thing he said to me was that aspartame will kill 200 million people.

There’s no real reason to address the Trocho, it has been covered here and within the scholarly community.

Is aspartame linked with sudden death?

People are even dropping dead from it. Go to http://www.mpwhi.com and read some of the doctor’s reports on sudden cardiac death. There are buttons at the top of the page.

The closest thing to a study to his “Reactions to aspartame containing products: 551 cases”, which I was unable to find the actual content of. However it was responded to by Magnuson et al ((Magnuson, 2007):

No information on the actual amount or duration of aspartame consumption was provided. No details regarding the selection process of reactors were provided. The most common were neurological symptoms including headache,dizziness, confusion and convulsions. Other symptoms were psychiatric (depression, irritability, anxiety) or visual and auditory disturbances. No data were provided regarding whether symptoms were self-diagnosed or were ever conﬁrmed by a medical expert

.. Basically anecdotal data no better than what ends up in AERS (which I’ve discussed elsewhere).Link 3: http://www.wnho.net/aspartame_msg_scd.htm
The Blaylock one is no better… just his opinion on the “real” cause of sudden athlete deaths. Even better, it’s from PRWeb, which is simply a self-submitted entry into “news” sources.

Link 4: http://rense.com/general82/gcar.htm
Discusses George Carlin’s death from heart attack, and then goes on to discuss the study from above which found a correlation between consumption of diet drinks and cardiovascular disease. It also contains the full body of Link 2.

Link 6: Limited-Edition Diet Coke Can For The Heart Truth Revealed!
Huffington Post link that actually 404s. The same article is on stylelist.com. In any case, this isn’t even a anti-aspartame article but actually was part of a promo campaign. Betty Martini’s instructions are to go and leave negative comments. Good times.

Also, if you read the United Press International 8 month investigation of aspartame you will see that it took Don Rumsfeld to get it on the market.

This is more of the same of the type of stuff from the Sweet Misery documentary… lots and lots of quotes from various people about how bad aspartame might be, or how it shouldn’t have been approved, and so on. What it does not have is citations for evidence linking aspartame to actual ills. The longer that aspartame is on the market, the more clear it becomes how much it is not leading to some crazy epidemic of… anything.

REFERENCES

Lutsey, Pamela L., Lyn M. Steffen, and June Stevens. “Dietary Intake and the Development of the Metabolic Syndrome The Atherosclerosis Risk in Communities Study.” Circulation 117, no. 6 (2008): 754-761.

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In the first part (read here) of my “fact check” on the Sweet Misery documentary, I mainly covered the claims that it leads to neurological disorders or is otherwise inherently unsafe. In this second part, the focus turns to the process of aspartame approval. The research for this turned out to be interesting, especially as occasionally the claims in the documentary would have a small nugget of truth buried in them. Sometimes they may even be wholly true, but still essentially meaningless. It is quite clear that aspartame does not lead to brain tumors. So claims that there were mismanaged studies that could have demonstrated this in the 70s are pointless, as we now know that aspartame does not cause cancer.

In this part I will generally only cover claims for which I can find some sort of documentation one way or another. Frequently the speakers in the documentary will say that they spoke to so-and-so at the FDA or Searle, or were shown some document, but no evidence is provided nor is there necessarily a way of disproving the statement. There are also claims about behind the scenes shady dealings of Donald Rumsfeld and other leaders of Searle and the FDA. But I have to consider it speculation and hearsay without some any evidence to back them up.

Claim: The “Bressler Report” found a 115-week DKP rat study to be fatally flawed

Around minute 27 of the documentary, Russell Blaylock discusses a 115 week DKP (diketopiperazine) rat study that the FDA had concerns with due to some inaccuracies in the collection and reporting of data. He mentions that the “Bressler Report” — the results of an investigation lead by Chicago division of the then-Bureau of Foods investigator Jerome Bressler — found that the DKP (and other) study was “horribly done research” and that there were tons of discrepancies. Assuming that the linked document on wnho.net is in fact the real Bressler report[1], then these are accurate statements. However, as best I can tell reading the actual report, Bressler never indicates that the discrepancies change these actual conclusions in a drastic way (Bressler 1977 [2]).

Page 68 has the summary of the some of the lesions and masses that were considered significant that were inconsistent with the submitted FDA study. It indicates that “for the most part” the pathology reports are “in agreement” with those of Searle. The report does find that the incidence of uterine polyps in the medium dose was 15% rather than 12%. This makes them potentially dose-related to the levels of DKP in the diet (which would seem to indicate that the rats did in fact consume the DKP and not avoid it). In the report summary, the “throwing out” of the tumors isn’t noted as significant.

On the face of it, it seems strange that when Bressler went to Searle to investigate the raw data, virtually none of the people who performed the study were available or had left Searle. Dr. K.S. Rao, the head of the study, had left and refused to be interviewed. While this seems fishy, it may be also be perfectly normal. Bressler was doing his investigation three years after the study had been submitted to the FDA (1974), with the study actually starting in 1971. There is a good chance that people were brought on from universities as interns, and that researchers were simply contractors there for the single study.

Claim: Rao / Waisman monkey study was covered up

Around minute 30, former FDA Investigator Arthur Evangelista begins discussing the “covered up” monkey study performed by K.S. Rao and Harry Waisman. He mentions that it had methodological issues. What he doesn’t mention is that Waisman died partly through the study, which led to it being terminated early. In other words, the study was never finished and yet Searle submitted what it had. Nonetheless, even based on the partial results, the FDA still opted to use it as the basis for the labelling for Phenylketonurics found on anything containing aspartame (much to the dismay of the Quaker company which pointed out that other protein-based components of its cereals contained much more phenylalanine than the aspartame had, making the warning confusing) due to the exhibition of seizure activity in medium and “high” dose groups. Note that even the “low” dose group was 32 times the estimated maximal intake (GAO [3]). A later similar study did not exhibit the same seizure activity as it spread out the food intake over a more normal period (rather than one massive spike at once… which the monkeys often didn’t finish) (Reynolds[4]). So, if anything, the criticised (by all) Rao/Waisman study found more problems with aspartame (specifically, the phenylalanine content) than actually appear to exist.

Evangelista also mentions that “1 or 2” died (it was one, and the cause was unknown). There were no seizures in the low dose group, which corresponds to about 32x the estimated maximal intake of aspartame. The seizures occurred in the medium and high dose (100 and 120 times maximal daily intake) and the authors note that this can be induced with the equivalent amount of phenylalanine by itself (so this is a known effect of phenylalanine, nothing special for aspartame here) (RAO p.11 [5],[6]). Another key point is that the low dose group never has the seizure, so there was apparently no “build up” of seizure-inducing chemicals (a favorite canard of the anti-aspartame folks).

In minute 32, Walton refers to his “independent review” of the peer-reviewed aspartame studies, finding that the positive ones were Searle-funded and the “independent” ones turned out against aspartame. I have covered this one before, as have others[7]. Virtually none of the studies he cites as “independent” are even studies, and certainly not peer-reviewed. Additionally, very few of them even directly address aspartame. For example, he will point to studies showing that large amounts of methanol can be bad. We know this. And this has has very little to do with aspartame. The couple that could be considered to directly address aspartame with negative consequences haven’t been reproduced or are of low methodological quality.

Specifically, it seems that only five of the mentioned studies could be considered to be peer-reviewed and directly relatable to aspartame:

The Camfield study (as mentioned in the title) only applies to children with a specific form of epilepsy. As noted in an American Academy of Pediatrics articlereviewing “inactive ingredients” in various pharmaceuticals, they simply recommend that children who have untreated epilepsy avoid aspartame in large doses (AAP 1997 [8]). A later study by Rowan and Shaywitz was unable to reproduce seizure activity in a controlled study of 16 adults and 2 children.

The Mahalik study was unable to be reproduced following the same methods by McAnulty et al (McAnulty 1989 [9]). The primary difference in their methods is that Mahalik et al did not use concurrent controls, but rather used historical controls. Note that McAnulty appears to have been employed by the NutraSweet company.

The Pinto study, like the Camfield one, relates to seizure activity, specifically around the phenylalanine content. As has been noted in other articles, aspartame is actually a relatively low source for phenylalanine and the results really only apply, potentially, to sufferers of PKU.

The Trocho study is about the formaldehyde/methanol concentrations. I discuss this in my first aspartame article . But in short, Tephyl et al notes that this study does not really apply to actual animals. Formaldehyde has never been demonstrated to build up on the body (and is a normal metabolic byproduct throughout the day from fruit juices), even when large direct doses of methanol are given to monkeys.

The Van Den Eeden study found that among people who self-report headaches after aspartame consumption, a subset of them actually seem to get more headaches when given aspartame versus placebo.

But if you follow the first link you can look at the studies he cites and decide for yourself. I’ve classified them by what type of study they are (peer-reviewed study, letter or case study) and whether they find aspartame to be “harmful”.

Claim: The Commissioner of the FDA (illegally) overruled the Board of Inquiry decision regarding aspartame approval

It is true that the Commissioner of the FDA did overrule the Board of Inquiry’s decision following the Task Force’s investigation. In his view, there was ample evidence of safety and no real evidence for brain cancer (which was their final fear). The concern of some of the board members was that there were not enough rats in the study to detect a 5% increase in chance of brain cancer. At the time that the GAO investigated the approval process, the National Toxicology Program’s standards were still only barely above what Searle had already done (in other words, even then in 1987 there was not a requirement to be certain of detecting 5% increase) (GAO p.55-59 [10]). In the documentary, James Turner claims that the Commissioner was violating law when he overturned the decision, but this does not appear to the the case. According to Title 21, the Public Board of Inquiry is a scientific not a legal body (CFR [11]).

Another interesting tidbit is that the documentary (around minute 55) says that it was a “clear conflict of interest” that Searle paid for an independent analysis (by UAREP, a consortium of nine universities) of the studies submitted to the FDA. In actuality, the FDA simply required them to foot the bill for the analysis. It was in no way sponsored by Searle (GAO pp.30-31).

The Missing Executive Order

I hesitate to say “and then things get weird”, considering what this article is reviewing. But then things get weird. About an hour into the video, Turner claims that the first action by Ronald Reagan upon coming into office in 1981 was to sign an Executive Order removing the ability of the FDA to stop the marketing of aspartame. No such Executive Order exists. Regan’s earliest one was signed on January 28th (Federal Register [12]). Naturally, Betty Martini claims the order was signed between the 20th and 26th and has been covered up. Why the entire government would choose to cover up just that one Executive Order is beyond me. Frankly, it is this exact type of thing that should make you question the entire documentary (assuming you weren’t already, as we have reached the end of the 2nd part of the series of articles). Absence of evidence is not evidence of anything.

Conclusions

While there is no doubt that pharmaceutical/chemical companies do everything in their power to get things certified, it does not appear that the evidence supports the notion of massive cover-ups of a deadly poison leading to improper approval.

The next, and hopefully final, part will discuss the story of a woman convicted of murdering her husband who has become a cause celebe for anti-aspartame crusaders who believe it was actually an aspartame overdose that led to his death (despite the fact that no such thing has ever been demonstrated to ever occur).

[1] I am a bit skeptical of the introductory portion which claims that the “worst 20%” were actually held back by the FDA and that portion has been restored in this version of it. As far as I can tell, the “missing” 20% is actually the portion of the review that covered two other aspartame studies, not the DKP study.

[3]GAO (United States General Accounting Office). “Food And Drug Administration: Food Additive Approval Process Followed for Aspartame”. June 1987. GAO/HRD-87-46.

[4]Reynolds WA, Bauman AF, Stegink LD. “Developmental Assessment of Infant Macaques Receiving Dietary Aspartame of Phenylalanine” in “Aspartame: physiology and biochemistry” by Lewis D. Stegink. I believe that Stegink was associated with Searle in some capacity.

[5]Rao KS, McConnell RG, Waisman HA. “SC-18862: 52 Week Oral Toxicity Study in Infant Monkey”. October 1972. Note: Far as I can tell this was never published in a journal, so I have to assume that dorway.com has an accurate version of it

[6] Pedantic note. Throughout the internet and even in the documentary people refer to the Rao study as “SC-18862”. That is not the number of the study but rather the technical name (at the time) for aspartame. I would hazard a guess that it refers to “Searle Company”.

[7]aspartame.net “Aspartame Information replies to the New York Times”. 12 February 2006. Visited 15 July 2012. NOTE: aspartame.net is created by Ajinomoto North America, the makers of aspartame.

[11]CFR (Code of Federal Regulations) Title 21, Subpart B, S. 13.30. http://tinyurl.com/cfr21-13 (Visited August 26, 2011). I am not certain that at the time of aspartame approval the Board had more authority.

Introduction

I have covered aspartame twice before, but I thought to finally get it out of my system I would cover the documentary “Sweet Misery” which essentially contains all of the claims I have seen previously (and some of which I’ve covered) as well as the cast of characters which frequently pop up with this topic. In this way I can address the whole gamut of aspartame claims and be done with it.

For the most part, the movie amounts to 90 minutes of anecdotal evidence of aspartame causing all manner of harm. A few of the guests in the documentary at least have medical degrees, but their statements frequently contradict the best scientific evidence we have and are often backed only by books that they themselves have written.

As you read this, you will notice a trend in my thinking that I want to make clear now. As a non-scientist, I am only “qualified” to trust consensus scientific evidence. While it may turn out in the future that a series of high quality, reproducible, studies will emerge which demonstrate a link between aspartame and a number of neurological disorders, this has not occurred yet. A large body of anecdotes do not count as studies. Individual studies do not really even count as evidence against the large amount of existing studies. Odds are, individual studies (no matter what they find, for or against aspartame) are wrong in some way. It takes a volume of studies to create that proper body of evidence that leads to a consensus.

So you may read this paper and find yourself thinking “he is just trusting scientists, he is just trusting the government, but they lie to us/are bought by industry/are biased”. I do not trust scientists, I trust science. And the current science shows no link between aspartame and all of these disorders. You should not trust me. And you certainly should not trust a few people in a documentary. But I firmly believe you should trust the large body of actual, peer-reviewed, studies that make of the evidence, especially in the form of reviews of multiple studies which can aggregate the results. I have no evidence of wide-spread corruption and fraud in the scientific community in this regard. Individual cases, sure. That’s why you go with the wide body of evidence.

If you are convinced that anything that comes from “mainstream” science is flawed, you may as well stop reading now.

Cast of Characters

The doctors and patients in the video are all people who are violently opposed to aspartame. The patients are not random people they found who had these issues, but are actively engaged in the idea that aspartame causes any number of issues.

The “Experts”

Russell Blaylock is a retired neurosurgeon who writes and speaks frequently about “excitotoxins” (which is not very prevalent in the scientific literature). He even manages to bring autism into the picture. He is also anti-fluoride.

Jim Bowen is a former medical doctor who appears to believe in all manner of other conspiracy theories, especially those related to the “Zionist Conspiracy”. You can easily find him searching for “Jim Bowen aspartame” on Google. He also wrote a pleasantly-titled article called “Aspartame Murders Infants”. He also appears as one of the sufferers in the video.

Arthur Evangelista is apparently a former FDA investigator (not sure how to confirm or deny this) who, ironically enough, runs a company that helps herbal supplement company “avert” oversight by the FDA. His PhD is in “Industrial and Occupational Safety”, not biochemistry, biology, chemistry, etc.

HJ Robertsappears to be/have been a doctor, but now writes books against apartame. One aspect, at least, where he seems to be “right” is in his criticism of taking vitamin E supplements in large doses. That criticism appears to be backed by real science. But otherwise his views do not appear to fit with mainstream consensus science.

Ralph Walton is psychiatrist who believes that aspartame leads to number of neurological disorders. I have covered[1]his supposed list of 97 “peer reviewed” articles against apartame previously (in short, while it is a list containing about 97 items… most are not peer-reviewed, about aspartame, or even against aspartame).

Many of the sufferers in the video have websites and and are in business related to anti-aspartame and “natural” industries. However I could not absolutely positively identify them (I would rather not link to sites that turn out not to be the same person) and so will leave that as an exercise for the reader. But as far as I could tell, these were not simply people they found off the street who were affected by aspartame, but rather fellow anti-aspartame crusaders.

The point is not to promote the genetic fallacy or perform an ad hominem attack, but rather to show that these are not necessarily “experts” who we should take at face value and that we should be extra sure to look into the evidence (or lack of) that they present for their claims. The claims must still stand or fall on their own grounds.

The Claims

Claim: Studies show a growing trend of multiple sclerosis, brain tumors, diabetes,etc in recent years linked to the introduction and usage of aspartame

Claim is made in first three minutes of video by the narrator, Russel Blaylock and HJ Roberts.

HJ Roberts says he noticed “conflicting” themes and that the rise was not due to lack of adequate scanning devices and that other cancers stayed the same while brain cancer incidence went up.

It’s not clear what studies are showing this trend (as the documentary doesn’t have a list of sources), but, at least for brain tumors, the incidence has bounced up and down and in fact started going up before aspartame was introduced, and went back down between 1990 and 2002.

Brain Tumors

From 1990 to 2002, the overall age-adjusted incidence rates for brain cancer decreased slightly; from 7.0 cases to 6.4 cases for every 100,000 persons in the United States. The mortality rate from 1990 to 2002 also decreased slightly; from 4.9 deaths to 4.5 for every 100,000 persons in the United States.[2]

“Incidence” refers to the numbers of new cases.

NCI Continues, “However, aside from the small percentage of brain tumor cases that can be linked to exposure to high-dose ionizing radiation or to certain inherited genetic alterations, few specific risk factors have been convincingly linked to brain tumors.”

They do mention that they are looking at “sweeteners” (among many other things) as potential causes, but studies were initiated in 1994 and I think I can show that aspartame has been ruled out quite well.

The Olney Study

I suspect that their “source” for the information in the first place, as the documentary makes reference to it, is the infamous J.W. Olney (mentioned above) study brain tumor “study” which looked at brain tumor incidence. The study has been highly criticised for cherry-picking the data and its methodology.

Questions regarding the safety of aspartame were renewed by a 1996 [the Olney study] report suggesting that an increase in the number of people with brain tumors between 1975 and 1992 might be associated with the introduction and use of this sweetener in the United States. However, an analysis of then-current NCI statistics showed that the overall incidence of brain andcentral nervous system cancers began to rise in 1973, 8 years prior to the approval of aspartame, and continued to rise until 1985. Moreover, increases in overall brain cancer incidence occurred primarily in people age 70 and older, a group that was not exposed to the highest doses of aspartame since its introduction. These data do not establish a clear link between the consumption of aspartame and the development of brain tumors. [3]

In 1996, Olney et al. published an article.. the authors concluded that there was a significant increase in the frequency of brain tumours in the mid-1980s, that is to say the period following aspartame came onto the market. The conclusions of this epidemiological study have been criticised by a number of scientists who questioned the methodology, the use of the data and their interpretation (Levy et al., 1996; Linet et al., 1999; Ross, 1998; Seife, 1999; Smith et al., 1998). One of the major criticism is that the authors only took into account the frequency of brain tumours during a selected period (1975-1992). When all the epidemiological data are used (1973-1992) a different conclusion is reached, as the frequency of brain cancers began to increase in 1973 and stabilised from the mid-1980s (Levy et al., 1996). Furthermore, Olney et al. did not provide any quantitative or qualitative relationship between the exposure of the population to aspartame and the observed frequency of brain tumours.

Additionally, there was a case-control study that attempted to demonstrate any sort of link, and failed to do so (Gurney 1997). [5]

In short, except for the Olney statistical analysis, all actual studies of humans and the data demonstrate no link between brain cancer and aspartame usage.

Multiple Sclerosis

Even the National Multiple Sclerosis Society does not support the claim that aspartame has anything to do with it. On their “Old Theories That Have Been Disproved” page, they put aspartame in there with allergies and owning a dog as having no scientific evidence linking it with MS. (National [6])

Or if you’re not a fan of the National MS Society, how about the Multiple Sclerosis Foundation? On their page “Examining the Safety of Aspartame”, they call out the “Nancy Merkle” hoax which kick started a lot of this nonsense and state pragmatically [7]:

While nothing can be considered 100 percent safe, aspartame has undergone extensive testing. With the exception of a few very mild side effects, aspartame appears to be quite safe. Those individuals, who experience problems after consuming aspartame, should eliminate foods and beverages that contain this sweetener from their diet.

I think it would stretch credibility quite a bit to believe that both of these groups are somehow “in the pocket” of the NutraSweet company.

Claim Summary

Misleading and wrong. Brain tumor incidence did go up, but not from aspartame. And incidence actually dropped in subsequent years (while usage of apartame has probably gone up). Aspartame did not cause a rise in brain tumors or multiple sclerosis. Not only is there no evidence linking aspartame with brain tumors, but when anybody actually tries to find evidence for it, the studies demonstrate nothing. So this is not a case of there just not being enough/no testing. There is a wealth of testing which has led to negative evidence of a link between aspartame and these disorders. So what opponents of aspartame mean when they say there hasn’t been “enough” testing is really that there hasn’t been enough that agrees with their view.

Claim: The components of aspartame break down into poisons and build up in the body over long periods of time to create toxic effects

Approximately minutes 4 to 7, with some later as well

Russell Blaylock – People say they take MSG, aspartame with no obvious effects. “Subtle toxic effects in those who don’t have obvious problems” Over long term will have disease.

… long term “Exposure to large amounts of the components of aspartame is toxicity”.

… “We know aspartame is a poison,it affects protein synthesis, and how the synapse operates in the brain. Affects DNA”

“aspartame with carbohydrates, reduces availability of L-tryptophan, an precursor for seratonin”

… “methyl ester becomes free methyl alcohol.. a real poison”

… “made sense that aspartame would lower seizure threshold”

… “Poisonous effect of methyl alcohol and ester is well known”

Lorena: Drinking water. “Searched for aspartame. Eyes lit up and started crying. I counted 79 of the 92 symptoms”

Methanol/Methyl Alcohol

I have a whole article essentially devoted to methanol/formaldehyde from aspartame that you can review, but I have looked a bit deeper for this current one[[10]]. While it is technically true that aspartame has methanol (and then formaldehyde) as one of its metabolic byproducts, it is also a bit of a red herring. Fruits break down into more methanol than numerous cans of soda. Meat contains much more phenylalanine than aspartame.

Kirchner found .8 mg/kg of fresh orange juice and 62 mg/kg stored and canned (Kirchner 1957 [11]). Assuming my math is right, this would equate to about 0.2mg in a fresh 8oz glass, and about 15mg stored. Compare this with a single 12oz can of soda, which has about 150mg (on the high end) of aspartame, 10% (15mg) of which metabolizes to methanol. Nobody seems to think the orange juice is going to kill you. On the low end of aspartame concentrations, juices and fruits are going to have much more. And anti-aspartame advocates are well of aware of this, and simply claim that there are “protective factors” in these fruits, juices and wines that make it not matter. This is special pleading. There is no evidence that methanol from aspartame in fact builds up.

The actual reason for the toxicity of methanol is from the build-up of formic acid/formate from high acute ingestion of methanol within a single exposure (good luck finding a study that finds evidence of long-term build up… they all refer to acute exposure). There is no evidence that it builds up indefinitely over years. In fact, the formic acid is able to leave the body faster than it is produced. Formaldehyde by itself appears to not contribute directly to the toxic effects of high doses of methanol (McMartin 1978 [12]).

Scientists have in fact looked at whether or not there might be build up of formic acid or methanol in the blood following ingestion of aspartame… and there simply is not.

Lewis Stegink performed a study finding no increased levels of formate after consumption if even “abuse” levels of aspartame (Stegink 1981 [13]). Stegink also has a larger review of the studies performed on the various components in aspartame, in which he discuses the results of that study and others which have looked into formic acid build-up:

blood and urine formate levels were determined in subjects administered the highest dose of aspartame (200 mg/kg body weight). No significant change in blood formate concentration was noted however, urinary formate excretion was increased significantly over preloading values in urine samples collected 0-4 h and 4-8 h after aspartame loading. Urinary formate excretion returned to preloading values in samples determined 8-24 h after loading. Because the rate of formate synthesis apparently did not exceed the rate of formate metabolism and excretion, blood formate levels were not detectably elevated. Thus, there appears to be little risk from aspartame’s methanol content at the doses studied (Stegink 1987 [14]).

In other words… the body easily gets rid of the byproducts via urination. When dri benking/eating products containing aspartame, you are not getting an acute dose of methanol that would cause harm. The normal metabolic processes of your body get rid of the methanol. If it didn’t, then you would have to avoid fruits and vegetables as well.

Phenylalanine

While people with the rare disorder phenylketonuria (PKU) should avoid products containing phenylalanine, diet soda and other “light” products are the least of their worries. A single can of soda is going to have ~150mg (0.150g) of aspartame. Let’s say 50% of that is phenylalanine, which would get you about 0.075g (75mg) in a can of soda.

So < 0.1g is well below many other foods that most people wouldn’t think twice about. Even if you drink 6 cans a day, you only get a little bit past the glass of milk but still nowhere near a hamburger.

Aspartic Acid

Aspartic acid is one of the “non-essential” amino acids, as our body is able to synthesize it on its own. In high doses, some would call it an “excitotoxin” but I can find little evidence of this being backed by scientific consensus. I have not seen too many specific claims against aspartic acid, so I don’t see any reason to talk too much about it.

Claim: There have been thousands of complaints to FDA about aspartame, more for neurological conditions

3:41 HJ Roberts – By 1988, “80% of complaints about food additives were for aspartame”. Where’s the evidence of this?

I covered this one a bit in my article entitle “Extraordinary Claims about Aspartame in the Huffington Post”. The fact of the matter is that there is no real evidence that the document shown in the documentary is legitimate. Even assuming it is, there are thousands of complaints about many additives submitted each year, but after investigation they are not reproducible. The list of 92 symptoms appears to come from yet another document by, not surprisingly, Betty Martini. As best I can tell, the scan of the document she (claims to have) received from the FDA is located on Scribd. But, as I will discuss below, the FDA (and others) has looked into the various reports and found no real causation.

The FDA does in fact have anAdverse Event Reporting System (AERS), where you can go and report effects you believe you’ve had (and naturally people have reported aspartame). The FDA uses this to compile alist of “potential” dangers that consumers and health officials should be aware of (FDA 2010, Potential [15]). However, you won’t find Aspartame listed in that current set. Or for that matter on any of thewarnings from 2008 to 2010.

I think it is useful to quote from the FDA here about what the AERS is and is not as it relates to causality (FDA AERS [16]):

AERS data do have limitations. First, there is no certainty that the reported event was actually due to the product. FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event. Further, FDA does not receive all adverse event reports that occur with a product. Many factors can influence whether or not an event will be reported, such as the time a product has been marketed and publicity about an event. Therefore, AERS cannot be used to calculate the incidence of an adverse event in the U.S. population.

If you would like to dive into the actual complaints available, there are data files you candownload. If aspartame were such a danger, there should be at least a few references for aspartame, but I don’t find any. You will however find aspirin in there, which makes sense as it is a potent and effective drug [17].

This documentary (and list shown on screen) show various neurological disorders that aspartame apparently causes, but the majority of these are diseases and disorders for which the the medical community does not have a known cause or cure. So of course we cannot definitively say “aspartame did not cause this.” However, aspartame most definitely is not in the running by any established or credible research agency into any of these diseases.

Tollefson and Barnarddid an analysis in 1992 of the 900 or so claims available at the time. They only looked into seizure related ones and found that the data “did not support the claim” of a linkage to seizures and aspartame consumption (Tollefson [18]).

A more overarching review was done by the CDC, and also found no reason to suspect a “widespread public health hazard” (but cautioned that were a small number that could be attributable to aspartame) (Bradstock 1986 [19]).

Claim Summary

There is always a chance that a small number of people have side effects from aspartame. Like any chemical, it can react to the body. But when apparent claims are looked into broadly, they come to nothing. And in the case of these specific symptoms, they are generic ones that we all go through for random reasons and rarely have obvious causes (itching, headaches, etc). So, if you feel weird after consuming aspartame stop consuming it. But millions of us consume it without ill effects. Both sides are anecdotal evidence, not science. The science shows that there is no effect across a broad spectrum.

Claim: People who stop consuming aspartame have their symptoms go away, and re-intake causes symptoms to come back

Approximately minutes 9 to 25, with some gaps. Claim is made by Joan (Goodman), Ed Johnson, HJ Roberts,Jim Bowen, Lorena Murray

“When I got off of NutraSweet, the symptoms stopped” … “My doctors will not say it is aspartame in the official records, but say it to the side” … “She didn’t have lupus or MS.. her husband made her stop drinking the diet drinks and the symptoms went away” … “I put the diet drink down, Friday the 19th… within 24 hours” … “When aspartame removed, the symptoms go away. That’s what you call strong circumstantial evidence”

HJ Roberts: “after they re-challenge themselves with aspartame, the symptoms come back, sometimes within minutes. That’s more than anecodotal. “That’s reproducing the problem. Many of these ‘aspartame reacters’ have testing themselves multiple times”.

Jim Bowen says with his patients when they go off aspartame it goes away. Says he developed therapeutic outlooks working with experts on environmental toxicology.

Not “more than” anecdotal

First of all, these various claims are not “more than” anecdotal. They fit absolutely into the very definition of anecdotal. Having a lot of (supposed) people making a claim does not suddenly carry the weight of actual science. The claim must be tested.

Definitions of ‘anecdote’/’anecdotally’:

From dictionary.com: “non-scientific observations or studies, which do not provide proof but may assist research efforts”

From oxforddictionaries.com: “(of an account) not necessarily true or reliable, because based on personal accounts rather than facts or research”

In other words, it stops being an anecdote when the claims are tested with an actual controlled study. For the case of multiple sclerosis, it does not appear that there is enough scientific plausibility to even warrant a study. As noted at the beginning, the various national MS foundations/groups absolutely do not support this claim. In the case of migraines controlled studiesfind no link (and sometimes a negative link!) [[20],[21]]. For brain tumors, no link. Seizures, very little link (except those with PKU). So, sure, start with anecdotes. But when the science shows no link, accept it and move on. Of course still follow the advice that applies for all food and drugs: If you get ill effects from using it, stop using it.

Relapsing-Remitting Multiple Sclerosis

The most common form of MS — 85% of people are initially diagnosed with this, versus 15% of the progressive form — is what is known as relapsing-remitting MS where the sufferer has occasional relapses, sometimes coming on suddenly over a period of days or even hours. This is followed by long periods, months and often years, of remission with complete recovery. RRMS affects women at a 2:1 ratio to men and it usually occurs in the 20s and 30s. After approximately 10 years, but even up to 30 years, later it will usually progress to Secondary-Progressive MS in which there is less remission. [[22]]

There is no way to know whether or not the people in the video actually had MS, or if they had the “popular” RRMS early form. But based on the fact that there is simply no scientific evidence of a link between aspartame and MS along with the assumption that those appearing in the video are telling the truth, the way that RRMS shows itself is at least a potential explanation for the apparent ability to make the symptoms “disappear” and reappear very quickly… as this is exactly what RRMS does. Couple that with the belief that aspartame is the “only” thing that changed, and you have a recipe for strong correlation without causation. Depending on the person, RRMS can slowly cause permanent degeneration of function and ability, which seemed evident in some of those in the video.

Also, interestingly, incidence of multiple sclerosis appears to increase as you get further from the equator (though this trend has apparently gotten weaker) and the female to male ratio is actually growing. I would definitely be very surprised if intake of aspartame also follows a distance-from-equator gradient. [[23]]

Conclusion

This article covered the first 30 minutes of the Sweet Misery documentary by Cori Brackett. This part looked at the initial claims that there has been a rising trend in various neurological disorders caused by the toxic byproducts of aspartame. I believe I have demonstrated that these claims are not backed by the scientific evidence. Not only does the scientific consensus not support claims that brain cancer and multiple sclerosis is related to aspartame intake, but the national public and private foundations for these ailments do not support the notion. Additionally, the individual parts of aspartame are contained in much larger quantities in foods that would be considered “harmless” such as fruit and meat.

If you feel weird after consuming aspartame stop consuming it. But millions of us consume it without ill effects. Both sides are anecdotal evidence, not science. The science shows that there is no effect across a broad spectrum.

I plan on doing two more additional articles to cover the full 90 minute movie so that I can be done with aspartame once and for all.

[1] DeWald, Joshua. “Aspartame and Formaldehyde: What does the science say?”. June 13, 2010.

One reason that consumers feel that organic food is better than “conventional” and worth a premium price is that it is supposed to be more nutritious. What is meant by “more nutritious.”? What specific nutrients are being referred to? Are there nutrients that conventional food has more of, but that are considered harmful? When I looked into it, there appears to be no real scientific support for the claim that organic food is nutritionally superior to conventional, or even that different. In this entry I will look at what the latest science has to say on the matter. Pesticides are not discussed.

The article is broken up into two parts. The first goes over Vitamin C and Nitrates, which are the two items that come up most often when discussing the differences between organic and convention — organic claimed to be higher in Vitamin C and lower in nitrates and therefore better. The second part looks at the actual systematic reviews that have been done on this very question from the most recent in 2009 to an earlier one in 2000. There is also an appendix in which I thought it would be interesting to talk a bit about the most frequent studies referenced by the reviews (basically, what did the reviewers review).

Notes on a couple of nutrients

Vitamin C

While in general there seems to be no difference between organic and conventional, my reading is that there might be a slight trend toward some fruits and vegetables having a higher ascorbic acid (Vitamin C) content, however this conclusion is not supported by the most recent and, arguably, thorough review. Regardless, in the case of Vitamin C, the recommended daily intake is about about 75-90 mg for an adult. 1 cup of the orange slices has about 95mg[1](USDA DB 2010). I have seen some references put a single orange around 75mg. So if you have an orange and some peppers or tomatoes in a day, you will be well above the amount your body can hold in any case and will just release it in your urine. So it would not seem to matter much, even if organic produce does have a trend toward slightly higher Vitamin C.

Nitrates

Even in more recent studies, conventional produce tends to have a higher nitrate content (generally due to differences in fertilizers), which proponents of organic food consider to be a major win. It seems that they are holding on to pre-2000 notions on the safety of dietary nitrate content. In 1945 there were 2 cases of methemoglobinemia (“blue baby syndrome”) in small infants which they traced to very high concentrations of nitrate in rural well water. This led to limits on drinking water levels of 10 ppm[2](EPA 2009). Additionally, In the 1970s it was believed that dietary nitrate was a potential carcinogen, but this conclusion was not able to be supported by the science done since then.

Research starting around 1994 demonstrated that dietary nitrate is actually quite beneficial in helping to fight disease pathogens in the mouth and gut. This is because it acts as an alternative source of nitric oxide[3], an important product in our bodies to help prevent stroke and ulcers (Lundberg 2008). Fascinatingly, its not our own bodies that does the conversion from nitrate to nitrite and nitric oxide, but rather symbiotic bacteria living in our mouths[4] and stomach (sounds gross, but is good!)(Duncan 1995). It seems in fact, that dietary nitrate presents no real health hazard to children or adults. There is also an entire book devoted to this question entitled Nitrate and Man: Toxic, Harmless or Beneficialby J. L’hirondel.

So it appears to be only infants < 6 months of age where there is any concern about nitrate levels, due to fears about methemoglobinemia (Greer 2005 [5]), and that isreally only related to contanimated well water used for formula and some very high nitrate-level foods (beets, green beans, squash carrots). Those foods have high nitrates on their own, switching to organic certainly would have no effect in this case, and the recommendation for small infants is to simply avoid them.

Note that these aren’t just obscure arguments in scientific journals, it has in fact been picked up by the media mainstream media (Minkel 2004 [6]) and blogs (pponline [7]). So it makes sense for earlier reviews (such as Worthington’s) to have called out nitrate as being exceptional, but there is currently no real reason that I can discern for lower nitrate levels in organic to make it any “safer”, especially given the amounts already present. Finally, the European Food Safety Authority (similar to FDA) put out a finding in 2008 that affirms the safety of leafy fruits and vegetables, considering their nitrate content with no link with cancer and some potential positive side effects (EFSA 2008 [8]).

What the Science Says

Looking over the history of the studies in this area, I think it may be interesting to actually approach this in reverse chronological order, starting from the most recent and comprehensive review down to one in 2000 that actually seems much less systematic in its approach.

2009 – Dangour, American Journal of Clinical Nutrition

The most recent review is “Nutritional quality of organic foods: a systematic review” by Dangour et al, published September of 2009 in the American Journal of Clinical Nutrition. The study was sponsored by the UK Food Standards Agency (equivalent to US FDA). Their primary finding was that (Dangour 2009 [9]):

There is no evidence of a difference in nutrient quality between organically and conventionally produced foodstuffs. The small differences in nutrient content detected are biologically plausible and mostly relate to differences in production methods.

I hunted down the full text and found a preview (so reader should note that I cannot say for certain that it represents the final published version). All additional details come from that document[10]. For the statistically inclined, they have made the raw data available (Food Standards Agency 2010 [11]). Now, that’s open science for you!. In the full text we find the specific nutrients:

Analysis of satisfactory quality-crop studies found no evidence of a difference in 8 of the 11 nutrient categories (vitamin C, phenolic compounds, magnesium, potassium, calcium, zinc, copper, and total soluble solids)

Looking more into the paper, it mentions that Phosporous and “titratable acidity” went to organic and Nitrogen content went to conventional.

Their study filtered through more than 52,000 articles (covering the years 1958 to 2008) to find 162 studies purporting to compare organic and conventional foods (both food and livestock), to arrive at 55 that actual met the standards of the systematic review.

Those standards were:

“The quality of research and reporting in this area is extremely variable. Each study included in the review was graded for quality based on 5 criteria addressing key components of study design: a clear definition of the organic production methods, including the name of the organic certification body; specification of the cultivar of crop or breed of livestock; a statement of which nutrient or other nutritionally relevant substance was analyzed; a description of the laboratory analytic methods used; and a statement of the methods used for statistical analyses. Studies were defined as being of satisfactory quality if they met all 5 criteria. We did not grade further the quality of organic certifying bodies or analytic methods used”

One would think that all systematic reviews on this topic would follow similar standards, but that is not the case. It is possible that the lack of specific certification body filtered out quite a bit of them because “organic” is not a concrete term, but rather is defined in practice by whichever certification bodies have been approved by the national governments. Their criteria could be more or less “strict” for different parts of the definition of “organic” and, for the case of the US, might not be the same “organic” recognized by the USDA (which simply means they cannot use the official labelling (USDA 2010 [12]).

Not surprisingly, the UK Soil Association (organic food lobby) was none too pleased with the study. Their primary complaint was that it did not cover herbicide/pesticide content. The study was explicitly about nutritional content, so it is a rather strange complaint (Soil Association 2009 [13]). They attempt to discredit even the nutritional part by listing out the differences that were found in the study. However, the figures are misleading because the standard error is sometimes more than the difference! But the Soil Association doesn’t mention that. For instance, they show copper has having an 8.6% difference (in favor of organic). But if you look at the data in the Dangour study, the standard error is 11.5, making the difference meaningless. They do however make a fair point that organic food is not just about nutritional content (clearly) or pesticides, but about the whole lifecycle of production. This precludes “conventional” farmers from making use of the techniques that they feel will best optimize production without actually attempting to have organic certification, which I highly doubt is the case in the real world.

So it seems that the most recent, and certainly the most rigorous, systematic review finds no real nutritional difference between organic and conventional food. That study stretches back to studies in the 50s and has a very clear definition of its entry criteria.

“Organic crops contain a significantly higher amount of certain antioxidants (vitamin C, polyphenols and flavonoids) and minerals, as well as have higher dry matter content than conventional ones.”

“Orv Hetil” appears to translation to something like “Health Weekly”.

So the results of this study are the organic crops are actually more nutritious. However, I don’t have a way of determining what studies they looked at, what criteria they used, or whether it was peer-reviewed.

“In spite of these limitations, however, some differences can be identified. Although there is little evidence that organic and conventional foods differ in respect to the concentrations of the various micronutrients (vitamins, minerals and trace elements), there seems to be a slight trend towards higher ascorbic acid content in organically grown leafy vegetables and potatoes. There is also a trend towards lower protein concentration but of higher quality in some organic vegetables and cereal crops. “

I managed to track down what appears to the full text by searching for the first few words of the abstract. It is hosted on docstoc.com, so I won’t link to it here as I am not certain of the legality of documents uploaded there.

So the only real finding other than that organic and conventional are virtually identical is another case of the trend toward finding slightly higher ascorbic acid/Vitamin C content in organic food. It strikes me as being a well done study without obvious bias. The authors go item by item and provide overview of the findings.

With the possible exception of nitrate content, there is no strong evidence that organic and conventional foods differ in concentrations of various nutrients.

Google Scholar also identified the full text article (available as of July of 2010), which is where I found the information about how the study was done and the number of them. The review is a good read, especially as it goes into detail into the study design (or lack of) as well as tests of significance (or lack of) employed by the researchers. One thing that becomes quite clear from reading this study is the true variability and complexity in looking at the nutritional effects of the organic production process.

In the end, as you can see from the quote, there is no real difference between organic and conventional especially if you look at studies in their own context.

Organic crops contained significantly more vitamin C, iron, magnesium, and phosphorus and significantly less nitrates than conventional crops. There were nonsignificant trends showing less protein but of a better quality and a higher content of nutritionally significant minerals with lower amounts of some heavy metals in organic crops compared to conventional ones.

I mention her profession because this is an alert to look closer at the study, and how it has been reviewed. By definition, a chiropractor who practices traditional chiropractic must ignore the majority of the science of illness in favor of the non-scientific idea of “subluxations” and “innate intelligence” as a basis for illness (Ernst 2008 [19]). So while her personal views do not actually make this study invalid, they lead to the reasonable suggestion that it may possibly cherry pick or otherwise perform improper analysis in the goal of coming up with a desired outcome. And if you read the article, she does seem to indicate that there was not much concern for how good a study was, rather they were just matched up. In any case, this is the earliest of the reviews and so did not have as good of studies to work with.

This one obviously found that trend for Vitamin C (and some others) in organic, as well as higher nitrate levels in conventional.

Conclusion

There does not appear to be any meaningful difference in nutrient content between organically-certified and “conventionally” grown produce. There is a possible trend toward higher Vitamin C content in organic, but for the levels found it would make no practical difference. The variance between any given two items of produce is so high that your specific organic fruit or vegetable is as likely to have less Vitamin C (or others) as any conventional one compared between themselves. Based on the scientific evidence, I see no reason to choose organically certified produce over conventional for purposes of obtaining higher nutrient content. This says nothing about other value/safety arguments that one might make (such as synthetic pesticide or sustainability), which I have not yet looked at, but plan to in a future article.

Appendix: Meta-meta review

For the reviews where I could get full text, or otherwise determine the the studies in use, I have created a table which has the reference, year and which reviewers used it. It is available as web page or as a CSV. It also includes a column for whether or not it found positive differences in organic, but I have not filled that out.

What I found intriguing is that there are only 4 studies that all of the reviews (except Gyorene, for which I could not find any full text version) agree was of high enough quality (or at least, met their criteria). A spattering more are in 2 studies, and the rest are in a single one, even for where the years overlap.

Just looking at these few studies you see that lack of meaningful trend. One might find organic higher for a given nutrient, and another will find organic lower for the same nutrient. Sometimes the same study had switches between the years the study was run.

The 4 that all “agree” on (though if you read Bourn, he references some more to point that they are frequently referenced but weren’t necessarily great studies):

Of interest, Smith is actually from a company called Doctor’s Data, which is high on the list of Stephen Barrett’s “QuackWatch” and in fact they are currently suing him for calling them out on their invalid analysis of urine and the like. This does not mean their analysis is fruits are incorrect, and at the time they may have been totally legitimate. Small world I suppose.

Raw levels are not noted, neither are statistical significance levels (so “90% more” could mean almost anything). As an example of how you could choose to read the results to support whatever conclusion you want:

Biodynamics is…interesting… and includes ideas from the “spiritual science of anthroposophy” (which is also what Waldorf education is based on) of Rudolf Steiner. What is strange is that one of their tenets is that holistically/biodynamically grown produce is more healthy and nutritious. Making it a tenet does not make it true.

“The concept of dynamic practic—those practices associated with non-physical forces in nature like vitality, life force, ki, subtle energy and related concepts—is a commonality that also underlies many systems of alternative and complementary medicine. It is this latter aspect of biodynamics which gives rise to the characterization of biodynamics as a spiritual or mystical approach to alternative agriculture. See the following table for a brief summary of biological and dynamic farming practices.”

This is actually a combination of the results of the next 2 (not a distinct study)

Main finding across them: “Given the number of factors evaluated each year for each of the four crops, there were relatively few differences in the yield, vitamin and mineral content of the vegetables grown using the two different production systems. We believe this was related to the proper use of fertility amendments and pest control practices. When quality compost is analyzed prior to use, vegetables can be provided with approximately the same amount of essential nutrients from compost as from inorganic fertilizers.”

[8]European Food Safety Authority. “Nitrate in vegetables – Scientific Opinion of the Panel on Contaminants in the Food chain”. Published 5 June 2008. Visited 4 Sept 2010. Available at <http://tinyurl.com/efsa-nitrate&gt;

The Huffington Post recently posted an article by Joseph Mercola which appears to be intended to be about how aspartame manufacturers have rebranded it in an effort to mislead the public (Mercola 2010 [[1]]). The author uses this as a jumping off point to make a large number of claims about the dangers of aspartame, much of which is uncited or outdated. In this article, I will respond to the claims with updated information (when available) and point out where there appears to be no credible source at all for the claim. Carl Sagan put best what will be a major theme of this article: “extraordinary claims require extraordinary evidence.”

The article starts light by stating the approval of aspartame was the “most contested” in FDA approval history. As proof, there is a link to the author’s own article (but not stated as such). I would not be surprised to find that nearly all major food additives go through a contentious process, and aspartame was no different. And they should, as this is a matter of safety and all concerns must be heard.

There is certainly still controversy over aspartame and its history, but it seems to be the stuff of conspiracy, not science. In any case, aspartame has been approved by the FDA, and has been safely in use for more than 20 years.

Mercola then moves on to the extraordinary claim (for which no references are provided) that aspartame was once listed as a “biochemical warfare agent claim”. I did manage to find another article on mercola.com where he makes this claim and appears to cite a source as a footnote reference. But there is no actual list of footnotes on that article, so there is no way to check here. Aspartame is most definitely not listed as a biochemical warfare agent and, without credible evidence stating otherwise, it seems unlikely that it ever was in a meaningful way.

Deceptive Marketing?

There is a small section about how some manufacturers have chosen to rebrand aspartame. Based on the title of the whole article, it seemed that this was one of the major points, but it does not take up much space. The gist is that the manufacturer Ajinomoto has rebranded aspartame as “AminoSweet”. It is already also known as NutraSweet and Canderel, so I am not certain what the argument is here. I suppose if one is assuming that aspartame is dangerous and that manufacturers need to “hide” the true nature, then it seems like something he would be mad at. But in no way is the danger demonstrated in this article.

Aspartame Wreaks “Havoc” On Your Health?

After the initial remarks about the history and name change, Mercola moves onto the heart of the article: claims about the dangers of aspartame consumption. This section mainly makes the claim that there have been thousands of complaints to the FDA about side effects of aspartame, and that this demonstrates that it is not safe. In the words of Mercola:

Did you know there have been more reports to the FDA for aspartame reactions than for all other food additives combined?

In fact, there are over 10,000 official complaints, but by the FDA’s own admission, less than 1 percent of those who experience a reaction to a product ever report it. So in all likelihood, the toxic effects of aspartame may have affected roughly a million people already.

This is another claim for which a reference (to the FDA in this case) would be appropriate. This one did not warrant even a link to mercola.com despite forming the basis of the entire section. Searching the Internet a bit, it is possible his source is something like this apparent portion of an email from “Betty Martini” (a person or alias that you can find quite a bit of anti-aspartame content on the Internet). You may notice that this is a link to a page hosted on fda.gov. This is not FDA-sponsored material, but rather comments and documentation that consumers can submit (FDA 2010[[2]]) as part of the approval or petition process. In makes reference of an “official” FDA compilation of 10,000 complaints, but does not actually link to the list. Again, however, this extraordinary claim is not backed by actual evidence.

The FDA does in fact have an Adverse Event Reporting System (AERS), where you can go and report effects you believe you’ve had (and naturally people have reported aspartame). The FDA uses this to compile a list of “potential” dangers that consumers and health officials should be aware of (FDA 2010, Potential[[3]]). However, you won’t find Aspartame listed in that current set. Or for that matter on any of the warnings from 2008 to 2010.

I think it is useful to quote from the FDA here about what the AERS is and is not as it relates to causality (FDA AERS [[4]]):

AERS data do have limitations. First, there is no certainty that the reported event was actually due to the product. FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event. Further, FDA does not receive all adverse event reports that occur with a product. Many factors can influence whether or not an event will be reported, such as the time a product has been marketed and publicity about an event. Therefore, AERS cannot be used to calculate the incidence of an adverse event in the U.S. population.

If you would like to dive into the actual complaints available, there are data files you can download. If aspartame were such a danger, there should be at least a few references for aspartame, but I don’t find any. You will however find aspirin in there, which makes sense as it is a potent and effective drug[[5]].

He lists the various neurological disorders that aspartame apparently causes, but the majority of these are diseases and disorders for which the the medical community does not have a known cause or cure. So there is no way to definitively say “aspartame did not cause this.” However, aspartame most definitely is not in the running by any established or credible research agency into any of these diseases. Tollefson and Barnard did an analysis in 1992 of the 900 or so claims available at the time. They only looked into seizure related ones and found that the data “did not support the claim” of a linkage to seizures and aspartame consumption (Tollefson [[6]]). A more overarching review was done by the CDC, and also found no reason to suspect a “widespread public health hazard” (but cautioned that were a small number that could be attributable to aspartame) (Bradstock 1986 [[7]]).

Mercola makes another remarkable claim:

Unfortunately, aspartame toxicity is not well-known by doctors, despite its frequency. Diagnosis is also hampered by the fact that it mimics several other common health conditions, such as [Multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, Fibromyalgia, Arthritis, Chronic fatigue syndrome .. Birth defects..]

In one statement, Mercola discounts the medical community at large’s ability to diagnose and recognize illnes and suggests and inability to recognize “aspartame toxicity”. This is a striking statement to make about the medical community. MDs (Dr. Mercola is a DO) are going to try their hardest to determine what causes ailments of their patients. If aspartame were a major concern, they would be aware of it.

This section based its claims on the idea of a massive wealth of documented evidence of side effects. This evidence was not provided. That is not to say that the FDA does not receive complaints about aspartame (probably more so in the past shortly after it was approved). But the available data do not indicate that the complaints have continued, nor is it recognized as being any sort of potential danger by the FDA or the CDC.

Diet Food and Drinks “Cause” Weight Problems?

Mercola then moves onto the claim that low-calorie drinks actually lead to obesity and weight gain. He again makes what looks to be a reference to prove his claim, but it is in fact another link to one of his own articles on mercola.com (which would be fine, except that it does not make it clear). Following the link, he references a study by Purdue University researchers published in Behavioral Neuroscience. In the study they tested whether or not rats would increase their calorie intake when a sweet taste was disconnected from actual energy content of the food (via non-nutritive sweeteners). They found that the results suggested the possibility that people could have increased obseity via those means (Swithers [[8]]).

We at last have a situation where Mercola has (indirectly) cited an actual study to back his claims. However it represents a single study done on rats in a slightly contrived situation. A latersystematic review of the larger body of research in humans (as well as rats) have found that in humans, non-nutritive sweeteners (NNS) do not generally seem to lead to increased energy intake due to confusing signals (emphasis mine) (Mattes [[9]]):

In one set of studies [Purdue]…It is unclear whether these findings can be extrapolated to humans who eat a more varied diet and when nonnutritively sweetened foods are ingested concurrently with high-energy foods (eg, diet soda with a hamburger, nonnutritively sweetened coffee with pie). Under such conditions, associative learning would be considerably more complicated and subtle. …

Other recent evidence indicates that learning does occur in humans, but is counter to predictions from the animal studies (153)…In short-term tests, participants failed to report increased appetite or energy intake in response to consumption of NNS, whereas nonusers of NNS reported heightened appetite and energy intake after such stimulation. These findings indicate inconsistent exposure to NNS (paired or not paired with energy) from beverages results in blunted responses to their consumption and no elevation in risk of weight gain..The implications of chronic, widespread use of NNS on taste-energy associations and their influence on appetite and feeding are questions open to study.

So based on a larger body of evidence, it seems that for users who do not frequently consume diet content, their senses won’t quite be used to the disconnect between the sweet signal and calorie content. However, it does not seem to actually lead to additional weight gain. Mercola did provide some evidence here, but it appears to be outweighed by a larger volume of studies directly relevant to humans though as always “more studies are needed.”

It get worse?

In the next section, Mercola continues about the apparent dangers of aspartame, which he has written a book about and encourages readers to get for their “loved ones”. He also restates that about two-thirds of side effects being neurological in nature, when more accurately it would be two-thirds (or whatever the figure might be) of claimed side effects. There are a couple of paragraphs discussing potential chemical reactions from aspartame that might lead to side effects in the brain. However the theories are un-sourced despite the specificity of the claims. Mercola mentions specifically migraine headaches and brain tumors.

While there were some early very small studies that seemed to link aspartame and migraines (Koehler 1987[[10]]), larger controlled studies found aspartame no more likely to lead to migraines than placebo, including in those who already believed they had aspartame-caused headaches (Shiffman 1987[[11]], Garriga 1991[[12]]).

As for brain tumors, it is likely that what Mercola has in mind is an infamous (and heavily criticised) data analysis performed by JW Olney (Olney 1996[[13]]). The study purported to demonstrate a marked increase in the incidence of brain tumors in the years following the approval of aspartame. The analysis has been criticised for choosing the years in such a way that the increase would seem to coincide with the approval, when in fact the increase started before aspartame was introduced, and has declined since (Butchko 2001[[14]]). Olney did not actually compare those who consumed aspartame with those who did not. A case-control study printed in the Journal of the National Cancer Institute was unable to reproduce any relationship between brain tumors (in children, who would be more sensitive) and aspartame (Gurney 1997[[15]]). It seems unlikely that the FDA would have kept aspartame on the market if there was any credible link between it and tumors, and presumably the Journal of the National Cancer Institute would not be pointing out the lack of effects.

Given that there has been no credible causal link between aspartame and any actual disorder, it is interesting that the article continues: ”

One of the reasons for this side effect, researchers have discovered, is because the phenylalanine in aspartame dissociates from the ester bond.”

Again, no source is cited for this very specific claim, so it is hard to actually look into. Additionally, this is an argument about phenylalanine (a component of aspartame), not aspartame. Any relationship would need to be identified with the whole, not its parts. Before attempting to identify the causes of “aspartame toxicity”, it would seem prudent to first demonstrate that aspartame toxicity actually exists.

Mercola then moves on to the idea of “excitotoxins”: “The aspartic acid in aspartame is a well-documented excitotoxin. Excitotoxins are usually amino acids, such as glutamate and aspartate. These special amino acids cause particular brain cells to become excessively excited, to the point that they die.”

Note again that this is referring to specific components of aspartame, not the whole. In any case, if you perform Google search for “excitotoxin”, you won’t find results that suggest that this is a mainstream idea within the medical community. While excitotoxity may be a valid idea, it does really seem to be appropriate to link it to aspartame. Excitotoxity seems to be mainly used to claim harmful effects of MSG (via glutamate). The two main researchers in the area are John Olney (who coined the term) and Russell Blaylock. Searches on those names (especially Blaylock) turns up interesting results which, to me, do not put them into the mainstream.

Dr. Mercola continues…

Excitotoxins can also cause a loss of brain synapses and connecting fibers. A review conducted in 2008 by scientists from the University of Pretoria and the University of Limpopo found that consuming a lot of aspartame may inhibit the ability of enzymes in your brain to function normally, and may lead to neurodegeneration.

According to the researchers, consuming a lot of aspartame can disturb:

The metabolism of amino acids

Protein structure and metabolism

The integrity of nucleic acids

Neuronal function

Endocrine balances

The review cited brings up methanol and the other “suggested” cause of “certain mental disorders” (Humphries 2008). It is in a peer reviewed journal, and I am not qualified to analyze it (nor do I have access to the full text). That said, it is not frequently cited and one of the few citations is actually a printed response from the same journal: “The premise of the review, that the high-intensity sweetener aspartame is neurotoxic, ignores a very large scientific literature to the contrary“ (Fernstrom 2009[[16]]). Much of scientific credibility is based on the notion of having your results cited and reproduced. In the case of the Humphries study, there is already prior overwhelming evidence of no link and so their analysis is out of step.

Mercola throws in a reference to the common claim about the dangers of aspartame with regard to formaldehyde. I just recently addressed this specific issue by looking at the studies around this claim, and there seems no reason to be concerned (Dewald 2010[[17]]). Despite the scary sound of “formaldehyde”, it is actually a completely normal part of the daily metabolic process, being produced in the amount of about 1.5oz a day (Formaldehyde Council 2007 [[18]]). Additionally, fruits and juices lead to a significantly higher volume of formaldehyde (Magnuson [[19]]) than aspartame.

Dr. Mercola makes a quick foray into the claims that aspartame is a carcinogen. He links to his own article discussing a European Ramazzini Foundation study (Soffritti 2006 [[20]]) attempting to link aspartame to tumors in rats. The article mentions that the European Food agency and US FDA intended on reviewing the study. Well, they did review it (FDA 2007[[21]]) and found (European Commission 2002[[22]]) that it was not of sufficiently high quality or controls to demonstrate a cancer risk, and affirmed the continued safety of aspartame. So this is another case where the article does at least cite a source, but it is either outdated or heavily criticised by the scientific and health community.

As part of his discussion on the apparent carcinogenicity of aspartame, Dr. Mercola makes reference (via mercola.com) to a “compelling case study” of a woman named Victoria Inness-Brown, who did a study of rats and demonstrated it caused tumors. It might strike you that the body of research on this topic is so sparse that he is forced to reference private citizens doing “research” which is even difficult for experts to perform. I challenge the reader to actually locate this study. It certainly wasn’t published in a journal (peer-reviewed or not). The only references I can find about it are old links to it, which now point to a generic landing page featuring credit card ads. But even reading his description I am suspicious. What happened in the control rats? The previously mentioned discredited Soffriti is the only study that seems to have legitimately attempted to look into this matter, and it was clearly found wanting.

How does one cure oneself of the desire for sweets?

In the next section, things take a bit of weird turn. Dr. Mercola discusses “Nutritional Typing™”, which is an offshoot of “Metabolic Typing” (a quiz-based approach apparently designed to determine the diet “tailored” to your metabolism). He provides a reference, which is again a link to an article on mercola.com which seems to be a long form ad for a book written by Dr. Mercola on how to determine your “Nutritional Type”. It is also possible to become certified in this technique, for a sum of money.

Dr. Mercola also mentions his solution for removing food cravings altogether in the form of his Meridian Tapping Technique (MTT). If you followed his reference (to a mercola.com page), you will come across the following quote:

Some people are initially wary of these principles that EFT [the former name for MTT] is based on – the electromagnetic energy that flows through the body and regulates our health is only recently becoming recognized in the West. Others are initially taken aback by (and sometimes amused by) the EFT tapping and affirmation methodology, whose basics you will learn here.

There is absolutely no scientific basis for the concept of “meridians”. They, their purpose, or their effects have never been found. It would quite reasonable to be “wary” of those principles he espouses until such time as controlled studies have been done that actually detect meridians or their properties. Bringing up meridians brings to mind acupuncture and other alternative claims using “Qi” (the supposed “energy flow” or “vital energy” brought from traditional Chinese culture, and frequently used as explanation for non-scientific beliefs) for which there is no scientific basis and for which scientific studies can find no effect above that of a placebo (Madsen 2009 [[23]]).

By way of evidence of how MTT is popular among practicing doctors, Dr. Mercola points out doctors who who have started using his MTT technique. The list does not include MDs (or even DOs as far as I can tell). The list is actually made up of:

Natural Health Clinics

Naturopathic Physicians

Pain Therapists

Emotional Therapists

Dr. Mercola also sells books and DVDs available for purchase to be able to fully harness the power of EFT/MTT.

This section seemed to be clearly the least objective of the article. The majority of it was made up of Dr. Mercola’s pointing to products and services made available by him and his company. No references are made to whether or not the techniques are scientifically credible or valid. They might be, but he offers no evidence. By now things have veered away from claims about the safety of aspartame.

An “acceptable” alternative?

Considering the tone of the rest of the article, it was surprising that Dr. Mercola would actually endorse any artificial sweeteners. But he does at least approve of Stevia, because it is a “safe, natural alternative” sweetener from a plant.

Yes, Stevia is “natural”, but is has had quite a bit of controversy itself. It was only in December of 2008 that theFDA gave it the “Generally Recognized as Safe” label (Curry 2008 [[24]]). Stevia is still banned from usage in the European Union (Stevia Association [[25]]). Recommending Stevia appears to me to be part of the common “natural fallacy” of regarding any substance that is closer to its original form as being somehow better than things which are “artificial” (even if the synthetic substance is chemically identical). There is plenty to be found in nature that is unsafe — arsenic, hemlock, poison ivy are some quick examples. While Stevia may actually be safe (and is approved in the US), it seems that Dr. Mercola recommends it purely on the grounds of it being “natural” despite having much less of a clinical track record of safety. Long term traditional usage is not the same as evidence.

Conclusion

The most common response to this article may be personal anecdotes of those who believe they were/are adversely affected by aspartame. To those, I just ask that you carefully read the studies which have looked for evidence of the plausibility and occurrence of it, and found none. It is human nature to look for patterns, and aspartame is so prevalent that removing it from your diet is not an isolated situation. Making that change removes any number of other habits and substances. Only your doctor could really help you determine what is causing migraines, seizures, etc.

Dr. Mercola’s article unfairly attacks aspartame, an artificial sweetener recognized and affirmed as safe by the FDA and used daily by millions of people without ill effects. I felt it important to point out the inaccuracies in the claims (and call for evidence of others) because if consumers get the impression that common products (be it food additives, medicines or medical practices) are unsafe they may seek out alternative treatments which have not been found to be safe, or may even have been found to be harmful.

Introduction

Aspartame, more commonly known as NutraSweet, is frequently claimed to have any number of ill effects in the body. This article will focus on the claim that aspartame contains formaldehyde, leading to toxic effects in the body (such as headaches), and will also touch on the claim that it is a carcinogen (cancer causing agent). There are additionally claims that aspartame leads to seizures, but this is a much less popular one (perhaps because the NutraSweet acknowledges the danger in the small amount of PKU sufferers for which it would affect). Hopefully the reader will be convinced it is true that one of the by-products of the breakdown of aspartame is formaldehyde, this does not represent any actual health hazard.

Just what is aspartame?

a methyl ester of the dipeptide of the natural amino acids L-aspartic acid and L-phenylalanine. Under strongly acidic or alkaline conditions, aspartame may generate methanol by hydrolysis. Under more severe conditions, the peptide bonds are also hydrolyzed, resulting in the free amino acids

Claims and Discussion

A common claim is that aspartame contains formaldehyde which builds up in the body and creates all manner of ills. Others have claimed that it is a carcinogen (cancer causing agent) despite there being no studies that really demonstrate that.

Mark D. Gold and Ralph Walton are two of the more prolific writers on this topic out there. Gold’s website has a section title “Formaldehyde Poisoning from Aspartame“, which has the following:

In 1997 there was an increase in aspartame users reporting severe toxicity reactions and damage such as seizures, eye damage and vision loss, confusion, severe migraines, tremors, depression, anxiety attacks, insomnia, etc. In the same years, Ralph Walton, MD, Chairman, The Center for Behavioral Medicine showed that the only studies which didn’t find problems with aspartame where those funded by the manufacturer (Monsanto).

Given the agreement amongst independent scientists about the toxicity of aspartame, the only question was whether the formaldehyde exposure from aspartame caused the toxicity. That question has now been largely answered because of research in the late 1990s.The following facts shown by recent scientific research:

Aspartame (nutrasweet) breaks down into methanol (wood alcohol).

Methanol quickly converts to formadehyde in the body.

Formaldehyde causes gradual and eventually severe damage to the neurological system, immune system and causes permanent genetic damage at extremely low doses.

Methanol from alcoholic beverages and from fruit and juices does not convert to formaldehyde and cause damage because there are protective chemicals in these traditionally ingested beverages.

The most recent independent research in Europe demonstrates that ingestion of small amounts of aspartame leads to the accumulation of significant levels of formaldehyde (bound to protein) in organs (liver, kidneys, brain) and tissues.

Excitotoxic amino acids such as the one which is immediately released from aspartame likely increases the damage caused by the formaldehyde.

What the science says

While it is true that aspartame does break down into methanol then formaldehyde, it actually happens much more in fruit juices (about 2x in a banana, or 6x in an 8oz glass of tomato juice2). Gold attempts to address this in item 4, but simply waves his hand as an explanation for why it can be ignored. The fact is that it simply is not enough to do anything and your body easily disposes of it.

The above quoted article has one of the more untrue statements you can find. Not only do “non-independent” researchers find no problems, “independent” ones did not either. Instead what you will find are people making hypothetical claims which are not backed by anything. Gold and Walton are excellent at taking a statement by one scientist and using it as an explanation for why aspartame has been found to be bad, when in fact it has not. In other words, they start with the premise that aspartame is harmful then look for explanations for why it might be.

The Walton set of research is frequently cited, but let’s break it down a bit. It actually was already rebutted here:

Dr Walton’s paper reveals that of the 92 pieces of “research,” 85 (not 84) are said to identify an adverse reaction to aspartame. However, of the 85:

Ten studies actually involve aspartate and not aspartame. Aspartate is the salt of aspartic acid. Aspartic acid is a very common component of food. These studies are therefore irrelevant to aspartame safety.

18 of the studies do not actually draw any negative conclusions about aspartame.

Five are review articles, not peer-reviewed studies.

Two are “brief reports” or “case reports”, not peer-reviewed studies.

Five are anecdotes, based on the writers’ observations of patients.

11 are conference proceedings, which are not peer-reviewed studies.

19 are letters to various medical journals.

Three are different reports of the same study.

Two are exact duplicates of other documents appearing in the list.

Three are different reports of the same allegations.

Overwhelming indeed. My own analysis is available here. What I found entertaining is how many of them (18 or 19) don’t even find anything negative… yet Walton, either brazenly or unknowingly, still includes them in his number. All in all, Walton is quite sloppy.
The only reasonable study (which I believe is also the one being referenced in #5 above), but still frequently questioned is:

Note the misspelling as “Vinds”… when it should be “Binds”. It’s generally cited as “Vinds” though.. a good indication that most of the sites claiming to do research are simply copy/pasting from this one guy.

…The administration of labelled aspartame to a group of cirrhotic rats resulted in comparable label retention by tissue components, which suggests that liver function (or its defect) has little effect on formaldehyde formation from aspartame and binding to biological components. The chronic treatment of a series of rats with 200 mg/kg of non-labelled aspartame during 10 days resulted in the accumulation of even more label when given the radioactive bolus, suggesting that the amount of formaldehyde adducts coming from aspartame in tissue proteins and nucleic acids may be cumulative. It is concluded that aspartame consumption may constitute a hazard because of its contribution to the formation of formaldehyde adducts.

One of the primary responses is from Tephyl, quoted by Butchko et al3:

However, according to Tephly (1999), the dose of aspartame used in the study (20 mg/kg body wt=2mg of methanol/kg body wt) would not yield blood methanol concentrations outside control values. Further, the administration of aspartame at 200 mg/kg body wt (equal to that in a single bolus of about 25 liters of beverage sweetened 100% with aspartame) to adult humans results in no detectable increase in blood formate concentrations (Stegink et al., 1981). Administration of [14C]methanol itself at 3000 mg/kg body wt to monkeys produces no detectable [14C]formaldehyde in body fluids and tissues (McMartin et al., 1979)…The lack of formaldehyde accumulation at very high doses of methanol question considerably the conclusion that formaldehyde adducts are forming from low doses of methanol (derived from high doses aspartame). Thus, Tephly (1999) concluded, “the normal flux of one-carbon moieties whether derived from pectin, aspartame, or fruit juices is a physiologic phenomenon and not a toxic event.”

To break it down:

Formaldehyde build-up has not in fact been detected even when 200mg/kg is given to humans (which is a huge amount)

Even when large does of direct methanol (which is what breaks down into formaldehyde) were given to monkeys, it did not produce formaldehyde build-up

There are other explanations for the labelled-carbon staying in the body, aside from formaldehyde build-up which will also occur with other substances (such as fruit pectin).

Going back to the original comments about Gold and Walton, we have a situation of someone trying to explain the build-up for formaldehyde, when no other scientists are able to actually see a build-up in the first place. Instead it seems that the labelled molecules are making their way through the basic chemistry of the process, but the full molecule is not.

Systematic Reviews

Let’s continue one with some of the large overviews which discuss the overall safety of aspartame in the broader scope, and occasionally look at studies purporting to show harm.

US Food and Drug Administration (FDA)

Both the FDA and the European Commission have determined that aspartame is safe. However they kicked off additional reviews in response to a study done by the European Ramazzini Foundation (linked here4) that claimed to demonstrate that aspartame was a carcinogen. The European review found this to not at all be supported by the data. The US FDA decided to do its own separate review of the study and had similar findings5:

FDA has completed its review concerning the long-term carcinogenicity study of aspartame entitled, “Long-Term Carcinogenicity Bioassays to Evaluate the Potential Biological Effects, in Particular Carcinogenic, of Aspartame Administered in Feed to Sprague-Dawley Rats,” conducted by the European Ramazzini Foundation (ERF), located in Bologna, Italy. FDA reviewed the study data made available to them by ERF and finds that it does not support ERF’s conclusion that aspartame is a carcinogen. Additionally, these data do not provide evidence to alter FDA’s conclusion that the use of aspartame is safe.

….

Considering results from the large number of studies on aspartame’s safety, including five previously conducted negative chronic carcinogenicity studies, a recently reported large epidemiology study with negative associations between the use of aspartame and the occurrence of tumors, and negative findings from a series of three transgenic mouse assays, FDA finds no reason to alter its previous conclusion that aspartame is safe as a general purpose sweetener in food.

Kind of interesting that the folks doing the study were not willing to actually submit it to a full review. If you take a look at the study’s tables (here and here), the bit that stands out to me is the lack of a consistent dose-response effect as you get higher doses of aspartame. They had to get up to an insane amount (2500mg/kg… or the equivalent of 500mg/kg for humans) to get a statistically significant effect.

European Commission – Scientific Committee on Food

For reasons unknown, people against Aspartame link to to the “European Commission updates their opinion” study as if the EC had determined that aspartame was now unsafe. The update was kicked off because of the Ramazzini Foundation study claiming carcinogenity. If you actually read the update, it is quite clear that they very much still find it to be safe.

The estimates of intake by mean and high level consumers are fairly consistent between European countries even though slightly different approaches were used. High level consumers, both adults and children, are unlikely to exceed the ADI of 40 mg/kg bw for aspartame. Special groups such as diabetics that are likely to be high consumers of foods containing aspartame are also well below the ADI. Therefore, from the available data it appears that no group is likely to exceed the ADI for aspartame on a regular basis.

All this is really saying is that the actual amount that most people would consume is well below the worldwide maximum level allowed (40-50 mg/kg).

If you view the table in the document, you can see that the mean is in the 2-3mg/kg bw/d, with high levels around 6-10.

Animal studies have demonstrated that the metabolic breakdown products of aspartame are absorbed and metabolised similarly whether they are given alone or derived from aspartame. The extensive presystemic metabolism of aspartame results in little or no parent compound reaching the general circulation.

This is in alignment to the Butchko/Tepyhl comments above: aspartame by-products (methanol, then formaldehyde) to not make it into the bloodstream.

And the key parts:

The aspartate component is rapidly metabolised and thus the plasma aspartate concentrations are not significantly elevated following aspartame doses of 34 to 50 mg/kg bw, whereas plasma Phe concentrations may increase depending on dose (Stegink, 1984). Methanol is also rapidly metabolised and blood levels are usually not detectable unless large bolus doses of aspartame (>50 mg/kg bw) are administered.

Trocho is discussed:

…Besides the fact that aspartame at high doses has never induced liver cancer in rats, Trocho’s studies did not identify the radioactivity found in the proteins and DNA. Consequently, the formation of adducts of formaldehyde on the proteins and nucleic acids from aspartame, in vivo, remains to be proved

French Food Safety Agency (AFSSA)

The AFSSA published its own systematic review (here hosted on the UK Food standards agency… FDA equivalent). They go over much of the same material as those above. On the subject of the aspartame leading to headaches, they have to say7:

Another study…was also a randomised double-blind placebo-controlled cross-over trial, concluded that aspartame was no more likely than placebo to trigger headaches (Schiffman et al., 1987). This study consisted of 40 subjects who complained of aspartame-related headaches… While 35% of subjects developed headaches while on aspartame, 45% developed headaches while on placebo.

I found it interesting that the Shiffman study actually used people who were already pre-disposed to believe that they got headaches from aspartame, and even then it could not be demonstrated.

Conclusion

The fact of the matter is there is not a convincing body of evidence (or none at all depending on how you look at it) to indicate that there is any reason to be concerned with normal intake of foods and beverages containing aspartame–unless you somehow manage to consume 12 liters of soda in a single sitting, in which case you have worse things to worry about. If there is interest, another article could focus on the supposed “excitotoxin” aspects of aspartame and some of the other proposed effects.The problem with these claims is that there is a large amount of urban myth around aspartame which do not have any studies (or reproduced studies) to back them up. They are essentially made up from whole cloth, which actually makes them more difficult to disprove. If there are specific studies that you have found convincing, then they could serve as a new jumping off point for another essay. Until then, there seems no reason to not consume diet beverages and other “light” foods.

Introduction

Impetus

This is part of my ongoing series of articles looking into the science around various popular claims (in the same vein as Brian Dunning of Skeptoid). My goal is not necessarily to “debunk” (though that will often be the result) but more to see what the actual scientific consensus is which may be different from what we are often told from friends or news sources. This is the third in the series, I previously discussed some anti-vaccination claims and energy drinks. In this case, a friend of mine suggested I look into the truth of the need for at least eight 8 ounce (“8×8) glasses of water a day.

Methodology

I have used the same method as in my previous entries. Namely, I do a quick search for the top sites making the claim(s). When they refer to their sources, which is itself infrequent, I look take a look at those studies (as well as others that cite them) to see if the studies actually match the claim. At times, the studies might turn out to have been superseded my newer research or discredited for one reason or another. Additionally I make heavy use of Google Scholar to locate studies on the topic. Wikipedia will often be a jumping off point, but will not itself be used as a source (for obvious reasons). Also, blogs and non-scientific sites are not considered sources for the side of “science” but will be used for the claim side. In this particular case, I did not end up using the “claim” sources as this topic is pop culture enough to not need to take up space with specific quotes.

Summary

I was actually surprised to find out that the recommended intake of water was in fact in the range of 90 ounces (2.7L) for women and 120 ounces (3.7L) for men (really it depends on age and weight). In other words, more than 64 ounces. However, at least 20% of this will come from your daily food intake. More importantly it is incorrect to claim that tea, soft drinks and coffee don’t count toward the intake, when in fact they do. Mildly alcoholic beverages have been found to show a small increase in the time it takes to rehydrate from exercise. So there is absolutely no need to feel obligated to down 2 full liters of plain water daily. The average person gets pretty well within range of the recommended intake without trying too hard.

Disclaimer

None of what is written here should be construed as medical advice, as I am certainly in no way qualified to provide that.

The Claims

Claim 1: An adult requires 64 ounces (“8×8”) of water a day

What the science says

Intriguingly, the recommendation of the Institute of Medicine (IOM) is actually a bit higher for a normal adult. Taking a look at the “Dietary Reference Intakes: Electrolytes and Water” published by the Institute of Medicine’s (IOM) Food and Nutrition Board, female adults should have 2.7L/day and males should have about 3.7L. However, they state that “about 20%” of that will come from food, leading to about 2.16L (73oz) and 2.96L (100oz), respectively, that should be consumed in liquid form[1].

This is technically an average, as the actual recommendation is really based on your weight (so bigger folks like myself actually need more). The best number I can find is about 35 mL/kg[2], which translates to about .5 oz/pound. So someone around 170lbs would “need” about 80 or so ounces, while someone closer to 200 pounds would go for 100 ounces.

According to J. Papai (65), P. Thomas has suggested a different origin for 8 × 8. Thomas reminds us that in 1945 the Food and Nutrition Board of the National Research Council wrote (31): “A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods.”

Thomas suggests that the last sentence was not heeded, and the recommendation was therefore erroneously interpreted as eight glasses of water to be drunk each day.

Summary

The current recommendation is in fact to consume about about 2.5-4L of water a day, of which at least 20% will come from food and that soft drinks and mild alcohol count toward (discussed below). If you look for it, there is also some controversy that the suggested amount is higher than necessary.

Claim 2 : Soft drinks, coffee and alcoholic beverages don’t count

So we’re supposed to have at least 2L of water a day, but that has to come from plain drinking water. Or does it?

What the science says

The AIs provided are for total water in temperate climates. All sources can contribute to total water needs: beverages (including tea, coffee, juices, sodas, and drinking water) and moisture found in foods. Moisture in food accounts for about 20% of total water intake. Thirst and consumption of beverages at meals are adequate to maintain hydration.

So right off the bat the most official recommendation that I’m aware of contradicts popular knowledge.

This preliminary study found no significant differences in the effect of various combinations of beverages on hydration status of healthy adult males. Advising people to disregard caffeinated beverages as part of the daily fluid intake is not substantiated by the results of this study. The across-treatment weight loss observed, when combined with data on fluid-disease relationships, suggests that optimal fluid intake may be higher than common recommendations. Further research is needed to confirm these results and to explore optimal fluid intake for healthy individuals.

Additionally, in a controlled study where one group consumed a standard diet (except with no water, but other beverages) and another had a diet including plain water they concluded “Inclusion of plain drinking water compared to exclusion of plain drinking water in the diet did not affect the markers of hydration used in this study.“[6]

The exception appears to be (at least) for those who are just now restarting to drink caffeine after having abstained for a week or so. Basically the body very quickly adapts to counteract the diuretic effects. In a literature review published in the Journal of Nutrition and Dietetics, the authors found [7]:

The available literature suggests that acute ingestion of caffeine in large doses (at least 250–300 mg, equivalent to the amount found in 2–3 cups of coffee or 5–8 cups of tea) results in a short-term stimulation of urine output in individuals who have been deprived of caffeine for a period of days or weeks. A profound tolerance to the diuretic and other effects of caffeine develops, however, and the actions are much diminished in individuals who regularly consume tea or coffee. Doses of caffeine equivalent to the amount normally found in standard servings of tea, coffee and carbonated soft drinks appear to have no diuretic action.

In terms of alcohol, in a study looking at fluid balance recovery after exercise, “there appears to be no differencein recovery from dehydration whether the rehydration beverageis alcohol free or contains up to 2% alcohol, but drinks containing4% alcohol tend to delay the recovery process.” [8]

Summary

The actual IOM recommendation specifically mentions that non-water beverages fully contribute to the intake. At least one study indicates that mildly alcoholic beverages have a mildly net diuretic effect. One study found no difference in hydration of folks who did not intake any plain water.

3 Valtin, Heinz. “‘Drink at least eight glasses of water a day.’ Really? Is there scientific evidence for ‘8 × 8’? Am J Physiol Regul Integr Comp Physiol 283: R993-R1004, 2002. First published August 8, 2002; doi:10.1152/ajpregu.00365.2002 – I would highly recommend my readers take a look at this if they want a more comprehensive look into this topic.